New Delhi: It is said that the waist is a terrible thing to mind. But now it will be the waist circumference or waist-to-height ratio that will decide if you are obese or not. Even if your Body Mass Index (BMI) is normal, you could be termed ‘obese' if your waist exceeds the new assessment criteria.
This conclusion stems from research published in the journal ‘Elsevier', which has defined new obesity criteria specifically for the Indian population.
Based on updated obesity standards, the principal measurement for determining abdominal obesity is waist circumference. Abdominal obesity is indicated when measurements reach or exceed 80cm for women and 90cm for men. Additionally, the waist-to-height ratio offers another assessment method, with readings above 0.5 indicating abdominal obesity. The method should also be preferred over the waist-to-hip ratio.
The collaborative study by NDOC, Fortis CDOC Hospital for Diabetes and Allied Sciences, and AIIMS Delhi provides new perspectives. The revised classifications better address obesity-related health concerns common among Asian Indians, including dyslipidemia, cardiovascular ailments, non-alcoholic fatty liver disease and obstructive sleep apnoea.
After 15 years, the new classification for Asian Indians coincides with global criteria published in ‘The Lancet Diabetes and Endocrinology'. The 2009 guidelines relied solely on BMI calculations, but recent research indicates BMI alone inadequately diagnoses obesity in this population.
Studies show that abdominal obesity in Asian Indians is strongly linked to inflammation and early development of associated health conditions, highlighting the importance of this revised definition. Additionally, it enables differentiation between ‘innocuous obesity' and ‘obesity with consequences'.
The researchers explain that categorising obesity cases into two distinct groups enhances understanding and treatment approaches. While some individuals maintain excess weight without apparent health issues, others experience significant medical complications, allowing healthcare providers to prioritise interventions accordingly.
Lead author of the study, Dr Anoop Misra, executive chairman and director of diabetes and endocrinology, Fortis CDOC Hospital, emphasised the importance of the findings. Pointing out that obesity rates in India are rising at an alarming pace and extending beyond urban areas, he termed the new guidelines "groundbreaking and easy to implement".
"They provide stage-specific strategies for managing obesity-related conditions across India, and also allow the application of weight-loss therapies to be applied early and optimally," he said.
The guidelines present a detailed two-tier system for categorising obesity. The assessment initiates when BMI surpasses 23 kg/m². The first stage recognises increased body weight without functional limitations. The second stage indicates severe conditions with enhanced abdominal adiposity, larger waist circumference or waist-to-height proportion, accompanied by a minimum of one functional restriction encompassing physical challenges, such as obesity-linked knee arthritis or obesity-associated medical conditions like type 2 diabetes, necessitating thorough treatment strategies.
Dr Naval Vikram, professor of medicine, AIIMS Delhi, who was the lead co-author of the study, said, "A distinct definition of obesity for Indians is crucial for the early detection of related diseases and the development of targeted management strategies. This study fills critical gaps in our understanding and offers a clear, rational approach to tackling obesity in the Indian population."